United Health Careers – Claims Clerk

Website UnitedHealthcare

Job Description:

The Claims Clerk is responsible for providing expertise or general claims support to teams in reviewing, researching, investigating, negotiating, processing and adjusting claims.

Job Responsibilities:

  • Work claims files to ensure the appropriate eligibility and provider records are matched to the claim
  • Consistently meet established productivity, schedule adherence, and quality standards
  • Analyze and identify trends and provide reports as necessary
  • Conduct data entry and re-work; analyzes and identifies trends and provides reports as necessary.
  • Provide general claims support by reviewing, researching, investigating, negotiating, processing and adjusting claims.
  • Identify more complicated claims and refer them to Senior Claim Processor or Supervisor
  • Authorize the appropriate payment or refers claims to investigators for further review.
  • Updates and maintains claims tracking database
  • Recognize claims by determining claim type – HCFA, Hospital, UB, and/or RX
  • Calculate other insurance and re-pricing benefits

Job Requirements:

  • Experience with computer and Windows PC applications, which includes the ability to learn new and complex computer system applications
  • Basic understanding of healthcare claims including ICD-9 and CPT codes
  • 1+ years of experience in an office setting environment using the telephone and computer as the primary instruments to perform job duties
  • High school diploma / GED (or higher)
  • 2+ years of data entry experience

Job Details:

Company:  UnitedHealthcare

Vacancy Type:  Full Time

Job Location: Dallas, TX, US

Application Deadline: N/A

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